Characteristics: Black cohosh is a striking, 3 to 9 inches’ tall plant and member of the buttercup family, found growing in hardwood forests in the USA and Canada (Kuhn and Winston, 2000). It has small white flowers and blooms from July to September. Black cohosh is called ‘black’ because of the dark colour of the plants medicinal roots (Castleman, 2001). The word ‘cohosh’ is Algonquin (native American) for ‘rough’, another reference to the roots.

History: Black cohosh was used medicinally by the Native Americans and they boiled the gnarled roots in water and drank the decoction for fatigue, arthritis, sore throat, and rattle-snake bite (Castleman, 2001). Black cohosh was also used by Native American women for gynecological problems and for recovery post child birth. Wild black cohosh grew most abundantly in the Ohio River Valley, which is fitting as the Eclectic medical school was located in Cincinnati on the banks of the Ohio. The Eclectics, who were America’s 19th century physicians, used the herb for fever, rashes, insomnia, malaria, yellow fever, gynecological ailments, myalgia, neuralgia, and rheumatic conditions (Castleman, 2001; Mills and Kerry, 2000). The Eclectic’s held the herb in very high regard and in King’s American Dispensatory, it is stated, ‘(black cohosh) is a very active, powerful, and useful remedy, and appears to fulfil a great number of indications… Few of our remedies have acquired as great a reputation in the treatment of rheumatism and neuralgia.’ (Felter and Lloyd, 1898).

Current applications: Black cohosh is a versatile herb, inherited from the Native Americans, and is one of their most powerful remedies still in use today. David Hoffman in his text, Holistic Herbal, mentions that black cohosh is a most powerful relaxant and a normaliser of the female reproductive system (Hoffman, 1988). He states it may be of use in painful or delayed menstruation, ovarian cramps, cramping pain in the womb, rheumatic conditions of all kinds including rheumatoid arthritis, osteoarthritis, and those involving muscular and neurological pains. He mentions it finds use in sciatica and neuralgia. It may be of use in situations where a relaxing nervine is required such as in labour and reducing spasms in whooping cough.

An old Native American remedy for rheumatism is black cohosh, prickly ash, burdock, and poke-root (Gladstar, 2000). Although poke root is a toxic herb and must be used only with great caution at very small doses. A famous formula for nervous afflictions, by the late Dr. Christopher called the ‘B&B formula’, was black cohosh, blue cohosh, lobelia, blue vervain, and skullcap in equal parts (Christopher, 1976). However, from an energetic standpoint this would be a rather cooling drying formula, so it is important to bear the constitution in mind. Black cohosh is quite a strong anti-depressant and is good for those people with depressive dark moods and fibromyalgia. It is sometimes combined with kava and ashwagandha for fibromyalgia in a triplet formula.

Safety: Moderate. Black Cohosh must not be used at the same time as Tamoxifen as it increases its effects. Black Cohosh should also be avoided in pregnancy and breastfeeding. If combining black cohosh with sedative drugs it is best to be extra cautious regarding dosage. There are reports black cohosh irritates the nervous system at high doses so it is best to stick with the lower dose range with this herb.

Dosage: Dose of tincture is 5-15 drops 2-3 times daily. Low doses are best with this herb.

Form: Rosemary Gladstar and Matthew Wood point out in Rosemary Gladstar’s text, Planting the future: saving our medicinal herbs, the tincture of black cohosh made from fresh roots is more effective than dried (Gladstar, 2000).

Scientific Summary

Research on models

Anti-inflammatory: A study identified a compound in the roots of black cohosh called cimiracemate A which suppressed TNF-α production in the blood macrophages ex vivo (Yang et al., 2009).

Anti-oxidant: One study found that an methanol extract of black cohosh can protect against cellular DNA damage caused by reactive oxygen species by acting as an anti-oxidant (Burdette et al., 2002).